[Pain therapy in herpes zoster and post-zoster neuralgia.].

Der Schmerz
T ZenzM Tryba

Abstract

Herpes zoster neuralgia and post-zoster neuralgia (PZN) are common disabling pain syndromes. While pain from acute herpes zoster is self-limited in most cases, as pain may disappear without treatment, post-zoster neuralgia is difficult to manage. Pathological findings in acute herpes zoster include infiltration of ganglia, demyelinization and loss of axons; yet the pathogenesis of pain remains largely unknown. In postzoster (often incorrectly called post-herpetic) neuralgia, peripheral and central origins are mentioned for the development of pain: selective loss of myelin-sheathed nerve fibres, sensitization of peripheral nociceptors, cross-talk between afferents and sympathetic efferents, deafferentation with somatotopic remodeling, virus-induced spontaneous activity, and nociceptive nervi nervorum. Pain shows no sex-specific differences, but there is a clear predominance in elderly patients over 60 years of age. In these patients aggressive therapy should be instituted. Numerous pharmacological, anesthetic and surgical approaches have been proposed for the treatment of pain in herpes zoster. Most approaches have been studied in uncontrolled settings. Treatment is most effective when installed early in the course of the diseas...Continue Reading

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Citations

Nov 5, 2002·European Journal of Pain : EJP·Peter HüglerHeinz Laubenthal
Feb 13, 2001·Environmental Research·C Winder
Mar 21, 2008·Der Schmerz·S Reiter-TheilM Zenz
Mar 9, 2004·Der Schmerz·A SchwarzerE Klaschik
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Jul 28, 2007·Der Schmerz·M Zimmermann
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Apr 12, 2006·Current Opinion in Clinical Nutrition and Metabolic Care·Kathleen M Gura, Mark Puder

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